Radial Nerve Palsy Following Humeral Shaft Fractures: A Prospective Evaluation of Management Strategies and Neurological Recovery

Abstract

Objective:  Humeral shaft fractures are known to be associated with radial nerve palsy, which is a major clinical issue because of the effects on the functionality of the upper limbs. The research aimed to assess management interventions and test the neurological recovery outcomes of affected patients.

Methods:  The study was designed as a prospective observational study to be carried out at Lady Reading Hospital, Peshawar. Two hundred and twenty patients with humeral shaft fractures and radial nerve palsy were selected. Neurological assessment and imaging findings were noted during clinical evaluation. Patients with open fractures, vascular injury, severe fracture displacement, suspected nerve entrapment or transection, or failure to demonstrate neurological recovery during follow-up were selected for surgical management, while the remaining patients received conservative treatment. 

Results: Among the 220 patients (mean age 34.5 ± 11.2 years), 140 (64%) were managed conservatively, and 80 (36%) underwent surgical treatment. Complete neurological recovery was achieved in 100/140 (71%) patients in the conservative group and 65/80 (81%) in the surgical group after six months. The mean recovery time was 12.5 ± 4.2 weeks in the conservative group compared with 10.3 ± 3.8 weeks in the surgical group. Early intervention was significantly associated with improved neurological recovery (p = 0.02), and fracture characteristics were also significantly associated with recovery outcomes (p = 0.04).

Conclusion:  Radial nerve palsy is a complication of humeral shaft fractures, which can be effectively addressed by a well-chosen method of treatment. Earlier diagnosis and intervention enhance functional outcome and neurological recovery.